Healthcare Provider Details

I. General information

NPI: 1194196592
Provider Name (Legal Business Name): DYSPHAGIA MANAGEMENT SYSTEMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5763 WILENA PL
SARASOTA FL
34238-1710
US

IV. Provider business mailing address

5763 WILENA PL
SARASOTA FL
34238-1710
US

V. Phone/Fax

Practice location:
  • Phone: 941-320-8930
  • Fax:
Mailing address:
  • Phone: 941-320-8930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberSA2829
License Number StateFL

VIII. Authorized Official

Name: CAROL GHIGLIERI WINCHESTER
Title or Position: PRESIDENT
Credential: MS SLP CCC
Phone: 941-320-8930